Herberger Katharina, Blome Christine, Heyer Kristina, Ellis Franziska, Münter Karl-Christian, Augustin Matthias
CVderm - German Center for Health Services Research in Dermatology, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Community Practice for Internal and General Medicine, Hamburg, Germany.
Wound Repair Regen. 2017 May;25(3):466-473. doi: 10.1111/wrr.12529. Epub 2017 Apr 27.
Lymphedema is a complex and burdensome medical problem and requires continuous specific therapy. The aim of this cross-sectional study of community lymphedema care in the metropolitan area of Hamburg, Germany, was to evaluate health-related quality of life (QoL) in lymphedema patients. Generic as well as disease-specific health-related QoL was assessed using EQ-5D and FLQA-LK, respectively. Pain was assessed using a visual analogue scale (VAS). About 301 patients (median age of 60.5 years, 90.8% female) with lymphedema of any origin were included. About 66.4% had lymphedema, 24.1% combined lipolymphedema, and 9.5% lipoedema. Mean disease-specific QoL (FLQA-LK) was 2.4 (range 0 = no to 4 = maximum burden). The highest impairment values were observed in subscales for physical complaints, everyday life, and emotional well-being. Mean EQ-5D VAS was 70.4, mean EQ-5D score 63.3. Lymphedema was associated with major impairments in QoL, which differed for subgroups of pain, clinical severity, and comorbidity. Pain as a common problem for lymphedema patients seemed to be underestimated and undertreated. Early diagnosis and structured treatment strategies are urgently needed.
淋巴水肿是一个复杂且负担沉重的医学问题，需要持续的特定治疗。这项针对德国汉堡大都市地区社区淋巴水肿护理的横断面研究的目的是评估淋巴水肿患者与健康相关的生活质量（QoL）。分别使用EQ-5D和FLQA-LK评估一般以及特定疾病的与健康相关的生活质量。使用视觉模拟量表（VAS）评估疼痛。纳入了约301例任何病因引起的淋巴水肿患者（中位年龄60.5岁，90.8%为女性）。约66.4%患有淋巴水肿，24.1%合并脂肪性淋巴水肿，9.5%患有脂肪水肿。特定疾病的平均生活质量（FLQA-LK）为2.4（范围0 =无至4 =最大负担）。在身体不适、日常生活和情绪健康子量表中观察到最高的损害值。EQ-5D VAS平均为70.4，EQ-5D评分平均为63.3。淋巴水肿与生活质量的重大损害相关，在疼痛、临床严重程度和合并症亚组中有所不同。疼痛作为淋巴水肿患者的常见问题似乎被低估和治疗不足。迫切需要早期诊断和结构化治疗策略。
